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Objectives. A nested case-control study was conducted in Miami, Fla, to determine risk factors associated with human immunodeficiency virus type 1 (HIV-1) seroconversion among injection drug users. Methods. The study identified 21 incident cases of HIV-1 infection and 76 unmatched controls from two longitudinal cohorts of injection drug users. One cohort consisted of individuals who originally had been recruited from treatment centers; a second cohort was recruited from the "street." Logistic regression analyses that adjusted for age, gender, and race were performed. Results. The final model determined that the primary independent risk factor that best explained the risk for seroconversion was sharing injection equipment in the year prior to conversion; a marginal risk factor was presence of sexually transmitted disease during this same period. Conclusions. Both an injection component and a sexual component play a role in seroconversion among injection drug users, although the injection component is much stronger. [ABSTRACT FROM AUTHOR]

Objectives. Most studies of risk factors for human immunodeficiency virus(HIV) rely heavily on retrospective self-reports. The degree to which these reports provide reliable information has received little research attention. The purpose of this study was to assess the extent to which the reliability of retrospective self-report data is affect over time. Methods. Data were examined from a longitudinal study of risk behaviors among injection drug users. Structured interviews were administered to 366 injection drug users who were asked to recall behaviors that they had reported 6, 12, or 18 months earlier. Results. Kappa coefficients showed moderate initial memory loss for injection and sexual risk behaviors. After 6 months, time had little effect on the ability of injection drug users to recall injection and sexual risk behaviors. For ordinal measures of risk, subjects who gave different reports over time were most likely to disagree by one response category. Conclusions. These findings support the use of retrospective self-reports in assessing HIV risk behaviors among injection drug users. Retrospective inquiry is likely to remain an important method for collecting data over time. [ABSTRACT FROM AUTHOR]

Objectives. This study was designed to assess and compare sex risk behaviors for human immunodeficiency virus (HIV) transmission of three drug user groups; injections who do not smoke crack, crack smokers who do not inject, and injectors who also smoke crack. Methods. Sexual risk behaviors for HIV were assessed among 246 drug users from Denver, Miami, and San Francisco. Respondents were classified into the three drug groups based on self-report and verified through urinalysis and physical inspection. Results. An increased risk for HIV through sexual transmission was associated with crack cocaine use, particularly among those who also injected. Crack smoking injectors were more likely to report sex with an injector, exchanging sex for drugs and/or money, drug use before or during sex, and unprotected sexual intercourse. They also injected more than injectors only smoked crack as often as smokers only, and reported higher overall frequencies of drug use. Conclusions. These findings, together with the higher rates of gonorrhea and syphilis reported by smokers and injectors/smokers, are indicators of the risk crack poses for the heterosexual transmission of HIV. [ABSTRACT FROM AUTHOR]

In spite of efforts to dissuade intravenous drug users (IVDUs) from donating or selling blood, some continue to do so. As part of a longitudinal study, 915 IVDUs in South Florida were interviewed concerning their history of donation or sale of blood and tested for antibodies to HIV-1 and HTLV-I/Il. Approximately 17 percent had either donated or sold blood during 1985 through 1988; most contributors (80.4 percent) sold to commercial blood services. IVDUs who had donated/sold blood were more likely to be male and not in drug treatment than were those who had not contributed blood. IVDUs not in treatment at the time of interview were more likely than IVDUs in treatment to have sold blood. Of those who had donated/sold blood since 1985, 19.6 percent subsequently tested positive for antibodies to HIV-l and 5.7 percent were positive for antibodies to HTLV-I/II. Increased effort is required to screen prospective donors and sellers, particularly at commercial blood banks. [ABSTRACT FROM AUTHOR]

Abstract: Needle/syringe combinations were collected from three shooting galleries in South Florida and tested for the presence of antibodies to HIV-1. Fifteen of 148 needles (10.1 percent) tested positive for HIV-1 antibody. Seropositivity rates did not vary by the day of the week of collection, nor by shooting gallery from which they were collected. When the needle appeared to contain blood residue, 20.0 percent were positive versus 5.1 percent with no blood residue. These findings suggest that needles/syringes used in shooting galleries are likely to serve as reservoirs and/or vectors of transmission of the HIV-1 virus, and that although visual inspection of the needle/syringe may be useful in lessening the chance for transmission, even the visually "clean" needles may result in transmission of infection. [ABSTRACT FROM AUTHOR]

The article discusses a study by D. C. Des Jarlais, K. Choopanya, S. Vanichseni et al. on AIDS risk reduction and reduced HIV seroconversion among injection drug users in Bangkok, Thailand. Skeptical criticisms have been contended by the proponents of behavioral risk reductions. The first was that drug users are unable to change their risk behaviors and such self-reports are not believable. Evidence have been provided which says that the criticisms do not hold in Bangkok. Users will change their behavior to reduce their HIV infection risk.